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NPI Code Detail

MEDICARE: SARAH L EVANS BA, CADC

MEDICARE: SARAH L EVANS BA, CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor06155IA

General Provider Information

NPI Number : 1639683063
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH L EVANS BA, CADC
Provider Business Mailing Address
First Line : 3451 EASTON BLVD
Second Line :
City : DES MOINES
State : IA
Zip : 50317-3214
Country : US
Telephone Number : 515-262-0349
Fax Number : 515-266-6808
Provider Business Practice Location Address
First Line : 3451 EASTON BLVD
Second Line :
City : DES MOINES
State : IA
Zip : 50317-3214
Country : US
Telephone Number : 515-262-0349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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